Sonographic findings of IgG4‐related disease of the salivary glands: Case report and review of the literature

Narayan, Anand K.; Baer, Alan N.; Fradin, Joel

doi:10.1002/jcu.22482

Cited by 23 publications

(21 citation statements)

References 18 publications

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“…Imaging is complementary and represents a reliable tool for assessing systemic involvement of IgG4‐related disease, response to immunosuppressive therapy, and disease relapse. US (for salivary glands), contrast enhanced CT scan, and MRI play central roles in differentiating active disease from organ‐specific damage related to fibrosis 150–154 . In general, active tissue inflammation and end‐stage fibrosis display characteristic radiologic features 152 .…”

Section: Introduction and Methodologymentioning

confidence: 99%

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European Guideline on IgG4‐related digestive disease – UEG and SGF evidence‐based recommendations

et al. 2020

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The overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra-pancreatic digestive organs, including IgG4-related cholangitis. Treatment with glucocorticoids should be weight-based and initiated at a dose of 0.6–0.8 mg/kg body weight/day orally (typical starting dose 30-40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2–4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi-organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added.

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Section: Introduction and Methodologymentioning

confidence: 99%

“…US (for salivary glands), contrast enhanced CT scan, and MRI play central roles in differentiating active disease from organ-specific damage related to fibrosis. [150][151][152][153][154] In general, active tissue inflammation and end-stage fibrosis display characteristic radiologic features. 152…”

Section: Q22: What Are the Imaging Features Of Aip? Statement 22mentioning

confidence: 99%

European Guideline on IgG4‐related digestive disease – UEG and SGF evidence‐based recommendations

et al. 2020

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“…First, bilateral homogeneous hypoechogenicity of the SMG should not be mistaken for salivary gland disorders such as autoimmune sialadenitis (Sjögren syndrome) or IgG4-related disease if the case involves no clinical suspicion of sialadenitis and no other concurrent US abnormality of the PG and SMG. Although Sjögren syndrome or IgG4-related disease may cause hypoechogenicity of the SMG, in most cases this can be differentiated from physiologic hypoechogenicity of the normal SMG by the presence of a heterogeneous echotexture, nodular hypoechoic lesions, asymmetrical involvement, and glandular enlargement or atrophic change [10][11][12][13]. Second, the echogenicity of the normal SMG seems inappropriate as a reference standard for assessing the echogenicity of thyroid nodules in cases of thyroiditis with decreased parenchymal echogenicity because, based on our study results, the normal SMG may exhibit physiologic hypoechogenicity.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic echogenicity of normal salivary glands in adults: comparison of submandibular and parotid glands

Choi

Paik

2021

Ultrasonography

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The normal submandibular gland (SMG) and parotid gland (PG) are thought to have similar homogeneous ultrasound (US) hyperechogenicity; however, this has not been extensively investigated. The aim of this study was to determine whether the normal SMG and PG have similar US echogenicity. Methods: We included 969 consecutive adult patients with normal salivary glands. The patients were categorized into three age groups: group 1 (19 to 29 years, n=27), group 2 (30 to 49 years, n=273), and group 3 (≥50 years, n=669). The echogenicities of the SMG and PG were prospectively evaluated by an experienced radiologist. Computed tomography (CT) attenuation in Hounsfield units (HUs) was quantitatively measured for the SMG, PG, and sternocleidomastoid muscle in 140 patients. Results: Relative to the PG, the echogenicity of the SMG was similar in 706 (73.0%) and homogeneously hypoechoic in 263 patients (27.0%). The frequency of SMG hypoechogenicity decreased with increasing age (group 1, 59.3%; group 2, 36.3%; group 3, 22.1%; P<0.001). The CT attenuation levels (in HUs) of the SMG and PG were significantly higher in patients with hypoechoic SMGs than in patients with SMG echogenicity similar to that of the PG (P<0.001). Conclusion: Hypoechogenicity of the SMG was observed in approximately one-third of this sample of adults with normal salivary glands. The SMG may be inadequate as a reference standard for evaluating thyroid nodule echogenicity in patients with diffuse thyroid disease with decreased echogenicity.

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“…A paciente aqui relatada apresentou pancreatite aguda, manifestação típica da DRIgG4, mas com evolução clínica e análise laboratorial inesperadas. As manifestações clínicas descritas desta síndrome relativamente nova decorrem da disfunção, com aumento de volume, de um único ou de múltiplos órgãos, o que ocorre em 60-90% dos casos [10][11][12][13][14][15][16] (Tabela 2). As características clínicas usuais são inespecíficas e compreendem linfadenopatia, sintomas de alergia ou de asma (40% dos pacientes), perda de peso e ausência de febre 17 .…”

Section: Discussionunclassified

Doença sistêmica relacionada à IgG4 com linfopenia: relato de caso e breve revisão de literatura

Mendonça¹,

Biegelmeyer²,

Assis³

et al. 2017

Arquivos De Asma, Alergia E Imunologia

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Sonographic findings of IgG4‐related disease of the salivary glands: Case report and review of the literature

Cited by 23 publications

References 18 publications

European Guideline on IgG4‐related digestive disease – UEG and SGF evidence‐based recommendations

European Guideline on IgG4‐related digestive disease – UEG and SGF evidence‐based recommendations

Ultrasonographic echogenicity of normal salivary glands in adults: comparison of submandibular and parotid glands

Doença sistêmica relacionada à IgG4 com linfopenia: relato de caso e breve revisão de literatura

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